A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood?
Decreased bilirubin
Decreased chloride
Elevated blood urea nitrogen (BUN)
Elevated HbA1c
The Correct Answer is C
Rationale:
A. Decreased bilirubin is unrelated to digestion of blood in the GI tract.
B. Chloride levels do not indicate blood digestion.
C. When a client with esophageal varices bleeds into the GI tract, the digestion and absorption of blood proteins lead to increased nitrogen load, reflected as elevated BUN.
D. HbA1c reflects long-term blood glucose control, not acute digestion of blood.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Percutaneous Transhepatic Cholangiography (PTC) involves inserting a needle through the skin into the liver to visualize bile ducts, not using endoscopy.
B. Endoscopic Ultrasound (EUS) uses an endoscope with ultrasound to image structures near the GI tract but does not combine with radiographic imaging of the ducts.
C. Magnetic Resonance Cholangiopancreatography (MRCP) uses MRI to noninvasively visualize bile and pancreatic ducts, without endoscopy.
D. Endoscopic Retrograde Cholangiopancreatography (ERCP) combines endoscopy with radiographic imaging to examine the bile and pancreatic ducts, allowing both diagnosis and therapeutic interventions.
Correct Answer is B
Explanation
Rationale:
A. Obtaining a dietary history is important but not the priority in an acute exacerbation.
B. Reviewing electrolyte values is the first action. Clients with acute ulcerative colitis are at risk for fluid and electrolyte imbalances due to diarrhea, making this a priority assessment to prevent complications.
C. Investigating emotional concerns is important for holistic care but is secondary to addressing physiologic needs.
D. Checking perianal skin integrity is necessary but comes after assessing critical physiologic risks like electrolyte imbalances.
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